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Longitudinal study of prevalence and antimicrobial resistance of thermotolerant Campylobacter spp. in German organic meat chicken farms.

Widespread prevalence of fluoroquinolone-resistant Campylobacter spp. in meat chicken is a major concern for public health. We examined the prevalence and antimicrobial resistance of thermotolerant Campylobacter spp. in 14 German organic meat chicken farms rearing slow-growing broilers, male layer hybrids, or dual-purpose cockerels in a longitudinal study. Most farms participated with four subsequent flocks. Each flock was sampled three times: approximately 1 month after hatching (before outdoor access), 2 weeks after first outdoor access, and at the end of the fattening period. Strikingly, most flocks were already Campylobacter-positive before first outdoor access. At the end of the fattening period, 98% of all flocks were positive, with C. jejuni being the predominant species. Antimicrobial resistance of 405 C. jejuni and 79 C. coli revealed overall high levels of ciprofloxacin and tetracycline resistance but absence of macrolide resistance. Ertapenem resistance was observed in individual farms. Generalized linear mixed models with random factors for farm and flocks within farm were used to assess predictors for the occurrence of ciprofloxacin- and tetracycline-resistant C. jejuni. Season, fattening type, and the interaction of sampling time point and fattening type were significant fixed effects. Results for flocks within farms showed clustering effects (ICCCIP = 0.447; ICCTET = 0.412). Whole-genome sequencing of representative isolates confirmed great overall genetic variety, with farm- or fattening type-dependent dissemination of certain multi-locus sequence types. ST21 clonal complex for sequenced C. jejuni and ST828 clonal complex for sequenced C. coli were most commonly detected.IMPORTANCECampylobacter spp. are major foodborne pathogens associated with the consumption and handling of chicken meat. This longitudinal study provides further insight into the prevalence and antimicrobial resistance of thermotolerant C. jejuni and C. coli in German organic meat chicken farms, a growing sector with strict limitations on antibiotic treatment. We included multiple flocks of farms fattening either slow-growing broilers, male layer hybrids, or dual-purpose cockerels to account for a variety of fattening types. Consequently, we were able to demonstrate significant differences in the occurrence of ciprofloxacin- and tetracycline-resistant C. jejuni based on fattening type, sampling time point, and season. Our findings highlight the successful spread and persistence of ciprofloxacin-, tetracycline-, and ertapenem-resistant C. jejuni and C. coli among all three types of organic meat chicken regardless of the lack of antibiotic treatment.

C. coli

Acute diarrhoea: Campylobacter colitis and the role of rectal biopsy.

Campylobacter spp. were the organisms isolated most frequently from 29 consecutive patients admitted with acute diarrhoea to an infectious disease unit. Rectal biopsies taken from 21 of the patients were abnormal in all but four, and in the patients with campylobacter infection there was a characteristic proctocolitis in each case. The histopathology was similar to that described for salmonella and shigella infections but clearly different from typical ulcerative colitis and Crohn's disease. Therefore in patients with acute diarrhoea we suggest that selective culture for Campylobacter spp. should be made a routine and that rectal biopsy has an important diagnostic role, particularly in patients with negative cultures.

Acute Disease

Campylobacter enteritis in South Australia.

Campylobacter jejuni was isolated on coproculture from 13 of 224 patients with suspected infectious diarrhoea whose faecal specimens were examined during a three-month period. These organisms were not isolated from 530 specimens received from asymptomatic and healthy individuals. Diarrhoea and cramping abdominal pain generally lasting two to three days were the major symptoms, though occasional patients had a more prolonged illness. Ingestion of campylobacter resulted in enteric infection with increasing numbers of campylobacter in the stool. Clinical laboratories should attempt to isolate these organisms from patients with diarrhoea.

Adolescent

Susceptibility of Campylobacter fetus subsp. jejuni to twenty antimicrobiol agents.

One hundred recent clinical isolates of Campylobacter fetus subsp. jejuni were tested by an agar dilution technique for susceptibility to each of 20 antimicrobial agents. Doxycycline and gentamicin were the most active of the drugs examined, inhibiting all strains at concentrations achievable in serum. Although the median minimal inhibitory concentration of erythromycin was low, 8% of the isolates were highly resistant. All isolates of Campylobacter fetus subsp. jejuni were relatively resistant to the beta-lactam antibiotics. Some strains were highly resistant to metronidazole and tinidazole.

Anti-Bacterial Agents

Improved media for growth and aerotolerance of Campylobacter fetus.

The microaerophilic nature of Campylobacter fetus has complicated its recovery from human and animal sources. In this study, modifications of brucella agar and broth were tested for enhancement of growth and aerotolerance of 64 strains of C. fetus, representing each subspecies. Brucella agar supplemented with 0.025% each FeSO4 7H2O, sodium metabisulfite, and sodium pyruvate, supported growth of 98, 77, and 63% of the strains at 6% O2, 17% O2, and 21% O2, respectively. Unsupplemented brucella agar supported growth of 94, 48, and 20% of the strains. Brucella broth supplemented with 0.2% FeSO4.7H2O, 0.025% sodium metabisulfite, and 0.05% sodium pyruvate supported growth of 98% of the strains at 21% O2, compared to 75% with unsupplemented brucella broth. With both the supplemented agar and broth, growth responses occurred 1 to 2 days earlier than usual. Growth and aerotolerance of three strains of Campylobacter sputorum subsp. bubulus were not enhanced by the supplements.

Campylobacter

The biochemical characteristics of Campylobacter-like organisms from cattle and pigs.

Examination of catalase-positive Campylobacter-like organisms from cattle and pig abortions, indicated the existence of two distinct biochemical groups. The group 1 strains, predominantly of intestinal origin, were identified as C fetus subspecies intestinalis whereas the group 2 strains appeared similar but not identical to C fetus subspecies venerealis. This second group of organisms was recovered from fetal and placental tissue of animals which aborted, however, the majority of strains were isolated only at 30 degrees C in media not generally employed for Campylobacter isolation. All of the strains from group 2 became aerotolerant on subculture.

Abortion, Veterinary

Acute colitis and bacteremia due to Campylobacter fetus.

An acute febrile illness with dysentery and colitis developed in a 26-year-old man following a wilderness outing. Campylobacter fetus ssp. jejuni was subsequently grown on blood cultures drawn during the acute illness and 9 days later when the patient was asymptomatic. Proctosigmoidoscopic and histopathologic evidence of acute colitis was present on admission and resolved on follow-up examination. Campylobacter fetus spp. jejuni infection should be considered in the etiology of acute infectious colitis.

Adult

The effect of different dissolved oxygen tensions on growth and enzyme activities of Campylobacter sputorum subspecies bubulus.

Campylobacter sputorum subspecies bubulus was grown in batch cultures in which the dissolved oxygen tension (d.o.t) was maintained at various constant levels. At a range of d.o.t. from 0.002 to 0.05 atm, which allowed good growth (mean generation time approximately 1.5 h), L-lactate was preferentially consumed before D-lactate. L-lactate oxidation was accompanied by equimolar acetate production during exponential growth. A value for YL-lactate (g dry weight bacteria per mol L-lactate) of 54 was determined. Net acetate production stopped when C. sputorum started to use D-lactate after consumption of L-lactate. When a culture growing exponentially at the expense of L-lactate was shifted from a d.o.t. of 0.02 atm to a d.o.t. of 0.15 atm, growth was impaired, and L-lactate consumption and corresponding acetate production diminished. This decrease correlated with a loss of lactate dehydrogenase activity after the shift. Campylobacter sputorum appeared to possess cytochromes of the b- and c-type and a carbon monoxide-binding pigment. Evidence is given that the principal site of oxygen damage is lactate dehydrogenase rather than the cytochrome chain.

Acetates

Electron microscopy of Campylobacter jejuni.

Stools from 56 patients with gastroenteritis were cultured for Campylobacter jejuni. The five strains isolated were examined by electron microscopy. The campylobacter cells were pleomorphic and most displayed appearances similar to those of V. fetus. Morphological changes were observed in cultures subjected to prolonged incubation.

Acute Disease

Campylobacter colitis.

Eleven consecutive patients with diarrhoea from whose stools campylobacter were isolated were investigated by sigmoidoscopy and rectal biopsy. Eight had definite proctitis, and in seven biopsy specimens were abnormal with histological changes ranging from non-specific colitis to gross colitis with goblet-cell depletion and crypt-abscess formation. Nine of the patients passed blood in their stools, and in all but one abdominal pain was a feature of the illness. Severe campylobacter colitis may be clinically, sigmoidoscopically, and histologically difficult to differentiate from ulcerative colitis and is a differential diagnosis in acute colitis.

Adolescent

Campylobacter colitis.

A patient is described in whom a campylobacter enteritis closely resembled ulcerative colitis on clinical, sigmoidoscopic, and histological grounds. Selective stool culture techniques may be necessary to differentiate campylobacter colitis from ulcerative colitis proper.

Adult

Campylobacter enteritis-an in-patient study.

During the first eight months of 1978, 26 patients were admitted to the Communicable Diseases Unit at King's Cross Hospital, Dundee with a diagnosis of campylobacter enteritis. The variety of clinical features encountered is described. Although diarrhoea occurred in all cases, it was preceded or accompanied by abdominal pain in the majority of cases and by fever in over half of the patients. The article emphasises the need to consider campylobacter infection in patients presenting with bloody diarrhoea, acute abdominal pain or pyrexias of unknown origin.

Abdomen

[Digestive origin of Campylobacter septicemias].

Whilst the animal origin fo human Campylobacteriosis is generally accepted, its epidemiology remains ill understood. Animal contact prior to a Campylobacter septicaemia is only rarely found. The frequent occurrence of episodes of diarrhoea immediately prior to the onset has led to a suspicion of a digestive portal of entry. Our aim is to provide incontrovertible proof of this hypothesis, reporting the results of systematic stool examinations for Campylobacter in the stools as well as 5 new cases of septicaemia.

Campylobacter Infections

Campylobacter fetus septicemia with concurrent salpingitis.

Campylobacter fetus was isolated from the blood of a nonpregnant young woman who had a clinical diagnosis of salpingitis. A description of the isolate of C. fetus is given. An increasing awareness of human infections and capability of growing this microaerophilic organism should contribute to our understanding of the incidence and virulence of this bacterium.

Adult

Campylobacter fetus associated with pulmonary abscess and empyema.

An unusual case of community-acquired necrotizing aspiration pneumonia with pulmonary abscess and empyema associated with Campylobacter fetus (formerly Vibrio fetus) in mixed culture is reported. This microaerophilic gram-negative curved bacillus has been increasingly associated with human disease. Unlike most pathogens associated with community-acquired aspiration pneumonia, this organism is usually resistant to penicillin. Infection associated with this organism is characteristically relapsing in nature and requires protracted antimicrobial therapy.

Adult

Septicaemia and meningitis with campylobacter fetus subspecies intestinalis.

Two cases of infection with Campylobacter fetus subspecies intestinalis are reported. In a 46-year-old farmer the development of septicaemic campylobacteriosis with acute gastroenterocolitis was favoured by malnutrition due to chronic alcoholism. After treatment with erythromycin the patient recovered completely. The second patient, a 40-year-old worker with meningitis, recovered after combined streptomycin-erytro-mycin therapy. In both patients antibodies against homologous and reference strains of Campylobycter fetus subspecies intestinalis, serotype 1 (Mitscherlich) were demonstrated in titres ranging from 1:16 to 1:64 by type the complement-fixation test.

Adult

Campylobacter enteritis associated with unpasteurized milk.

Campylobacter fetus ss. jejuni has recently been recognized as a human enteric pathogen. Laboratory isolation has been hindered by its fastidious nature. Methods for recovery of this organism from stool culture and a specific serologic test are described. An outbreak is reported in which three members of the same family became simultaneously ill with fever, severe abdominal cramps and diarrhea. C. fetus ss. jejuni was recovered from stool specimens from all three. A fourfold increase in serum immunoglobulin G (IgG) titer to this organism was demonstrated in each patient. All three patients had been consuming unpasteurized milk from a cow whose feces were infected with C. fetus ss. jejuni.

Adult